Provider First Line Business Practice Location Address:
900 S. AUBURN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-0128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-221-5033
Provider Business Practice Location Address Fax Number:
509-221-5551
Provider Enumeration Date:
05/01/2009