Provider First Line Business Practice Location Address:
222 N MISSION
Provider Second Line Business Practice Location Address:
SUITE 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-1648
Provider Business Practice Location Address Fax Number:
509-667-2114
Provider Enumeration Date:
11/13/2006