Provider First Line Business Practice Location Address:
230 GRANT RD STE B27
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:
98802-7715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-884-1437
Provider Business Practice Location Address Fax Number:
509-884-2811
Provider Enumeration Date:
11/02/2017