Provider First Line Business Practice Location Address:
2401 W DOLARWAY RD
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:
98926-9309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-647-7545
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2011