Provider First Line Business Practice Location Address:
200 N CHELAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-2105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-888-4866
Provider Business Practice Location Address Fax Number:
509-888-5116
Provider Enumeration Date:
05/18/2015