Provider First Line Business Practice Location Address:
2201 W DOLARWAY RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-8228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-952-5453
Provider Business Practice Location Address Fax Number:
509-925-2474
Provider Enumeration Date:
07/29/2011