Provider First Line Business Practice Location Address:
172A OLD TWISP HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TWISP
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-997-2037
Provider Business Practice Location Address Fax Number:
509-997-0402
Provider Enumeration Date:
12/26/2012