Provider First Line Business Practice Location Address:
401 AUSTIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-2407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-6422
Provider Business Practice Location Address Fax Number:
509-888-3816
Provider Enumeration Date:
04/10/2013