Provider First Line Business Practice Location Address:
205 W 5TH AVE STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-2887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-962-7527
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2025