Provider First Line Business Practice Location Address:
1201 S MILLER ST
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-667-2003
Provider Business Practice Location Address Fax Number:
509-667-2363
Provider Enumeration Date:
07/13/2005