Provider First Line Business Practice Location Address:
201 S MAIN ST
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:
98926-3609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-424-5899
Provider Business Practice Location Address Fax Number:
509-651-9971
Provider Enumeration Date:
04/22/2014