Provider First Line Business Practice Location Address:
2101 W DOLARWAY RD 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:
98926-7846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-925-2333
Provider Business Practice Location Address Fax Number:
509-925-2334
Provider Enumeration Date:
10/03/2007