Provider First Line Business Practice Location Address:
1014 WALLA WALLA AVE
Provider Second Line Business Practice Location Address:
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:
509-663-0034
Provider Business Practice Location Address Fax Number:
509-663-3182
Provider Enumeration Date:
02/02/2016