Provider First Line Business Practice Location Address:
800 S PEARL ST 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:
98926-3646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-925-6800
Provider Business Practice Location Address Fax Number:
509-925-6900
Provider Enumeration Date:
07/28/2014