Provider First Line Business Practice Location Address:
1311 S PERRY AVE # B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98802-5856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-630-5122
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/18/2015