Provider First Line Business Practice Location Address:
315 VALLEY MALL PKWY
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:
98802-4831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-884-5625
Provider Business Practice Location Address Fax Number:
509-884-5322
Provider Enumeration Date:
01/19/2007