Provider First Line Business Practice Location Address:
224 N 7TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASCO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99301-5411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-545-3390
Provider Business Practice Location Address Fax Number:
509-543-2488
Provider Enumeration Date:
01/23/2007