Provider First Line Business Practice Location Address:
1601 N AURORA AVE
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:
98802-4155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-670-0979
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2007