Provider First Line Business Practice Location Address:
5005 N HARVARD RD
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:
99027-9209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-592-7875
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2013