Provider First Line Business Practice Location Address:
980 EASTMONT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98802-6602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-664-0949
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/06/2020