Provider First Line Business Practice Location Address:
601 N MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-6304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-933-3300
Provider Business Practice Location Address Fax Number:
509-933-3311
Provider Enumeration Date:
04/09/2010