Provider First Line Business Practice Location Address:
1609 RUSSELL ST
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:
98801-3327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-630-5334
Provider Business Practice Location Address Fax Number:
602-636-5285
Provider Enumeration Date:
01/26/2015