Provider First Line Business Practice Location Address:
1 5TH ST
Provider Second Line Business Practice Location Address:
SUITE #100
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-6647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-665-0300
Provider Business Practice Location Address Fax Number:
509-664-4094
Provider Enumeration Date:
02/07/2007