Provider First Line Business Practice Location Address:
1300 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98844-9384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-476-2020
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/15/2008