Provider First Line Business Practice Location Address:
914 S SCHEUBER ROAD
Provider Second Line Business Practice Location Address:
PROVIDENCE CENTRALIA HOSPITAL
Provider Business Practice Location Address City Name:
CENTRALIA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-330-8720
Provider Business Practice Location Address Fax Number:
360-330-8737
Provider Enumeration Date:
11/23/2011