Provider First Line Business Practice Location Address:
603 N MISSION 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:
98801-2049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-663-1578
Provider Business Practice Location Address Fax Number:
509-663-0174
Provider Enumeration Date:
10/02/2007