Provider First Line Business Practice Location Address:
610 N MISSION
Provider Second Line Business Practice Location Address:
STE B-4
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-6611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-9624
Provider Business Practice Location Address Fax Number:
509-665-7205
Provider Enumeration Date:
07/28/2006