Provider First Line Business Practice Location Address:
825 SE BISHOP BLVD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PULLMAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99163-5537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-332-2517
Provider Business Practice Location Address Fax Number:
509-334-9247
Provider Enumeration Date:
09/29/2006