Provider First Line Business Practice Location Address:
823 N MILLER 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:
98801-2046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-6781
Provider Business Practice Location Address Fax Number:
509-662-6815
Provider Enumeration Date:
10/15/2005