Provider First Line Business Practice Location Address:
1206 N DOLARWAY RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-8392
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-933-2400
Provider Business Practice Location Address Fax Number:
509-933-4804
Provider Enumeration Date:
11/15/2013