Provider First Line Business Practice Location Address:
23 S WENATCHEE AVE
Provider Second Line Business Practice Location Address:
SUITE 124
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-2264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-860-0711
Provider Business Practice Location Address Fax Number:
509-664-4588
Provider Enumeration Date:
11/03/2009