Provider First Line Business Practice Location Address:
2225 N AIRPORT RD UNIT 18
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-9472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-855-1501
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/03/2022