Provider First Line Business Practice Location Address:
23903 E JOSEPH AVE
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:
99027-9777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-953-3079
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2023