Provider First Line Business Practice Location Address:
230 GRANT RD STE CB1
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:
98802-7724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-884-1020
Provider Business Practice Location Address Fax Number:
509-886-9290
Provider Enumeration Date:
05/23/2007