Provider First Line Business Practice Location Address:
400 E MOUNTAIN VIEW AVE
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:
98926-3767
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-933-7235
Provider Business Practice Location Address Fax Number:
509-933-7245
Provider Enumeration Date:
01/12/2007