Provider First Line Business Practice Location Address:
545 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHELAN FALLS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-812-2066
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/24/2021