Provider First Line Business Practice Location Address:
1139 PRINCETON AVE N
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-1436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-664-4013
Provider Business Practice Location Address Fax Number:
509-665-8543
Provider Enumeration Date:
04/16/2007