Provider First Line Business Practice Location Address:
1250 SE BISHOP BLVD
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
PULLMAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99163-5449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-332-7424
Provider Business Practice Location Address Fax Number:
509-332-7364
Provider Enumeration Date:
11/25/2006