Provider First Line Business Practice Location Address:
6400 W. OKANOGAN AVE
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:
99336-7686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-735-9820
Provider Business Practice Location Address Fax Number:
509-735-9821
Provider Enumeration Date:
03/01/2010