Provider First Line Business Practice Location Address:
4 KITTITAS ST
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-6008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-679-4556
Provider Business Practice Location Address Fax Number:
509-210-3234
Provider Enumeration Date:
12/20/2007