Provider First Line Business Practice Location Address:
1410 JOHN ST
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:
98801-6212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-667-9061
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2009