Provider First Line Business Practice Location Address:
835 SE BISHOP BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PULLMAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99163-5512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-336-7543
Provider Business Practice Location Address Fax Number:
509-336-7642
Provider Enumeration Date:
05/22/2008