Provider First Line Business Practice Location Address:
709 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-3640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-929-3000
Provider Business Practice Location Address Fax Number:
509-834-7414
Provider Enumeration Date:
09/01/2015