Provider First Line Business Practice Location Address:
5210 N HARVARD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OTIS ORCHARDS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99027-9282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-475-1551
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2022