Provider First Line Business Practice Location Address:
18 S MISSION ST
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-2203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-679-2380
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2015