Provider First Line Business Practice Location Address:
415 E MTN VIEW AVE
Provider Second Line Business Practice Location Address:
STE 301
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-5802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-933-2273
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2009