Provider First Line Business Practice Location Address:
1190 5TH 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:
98801-1825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-9671
Provider Business Practice Location Address Fax Number:
509-662-9672
Provider Enumeration Date:
06/06/2018