Provider First Line Business Practice Location Address:
630 VALLEY MALL PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
E WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98802-4838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-884-7254
Provider Business Practice Location Address Fax Number:
509-884-4698
Provider Enumeration Date:
07/30/2006