Provider First Line Business Practice Location Address:
11 SPOKANE ST
Provider Second Line Business Practice Location Address:
SUITE 203B
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-6132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-474-4355
Provider Business Practice Location Address Fax Number:
877-347-5455
Provider Enumeration Date:
12/22/2015