Provider First Line Business Practice Location Address:
400 E UNIVERSITY WAY
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:
98926-7502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-963-1886
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/15/2015