Provider First Line Business Practice Location Address:
3110 1ST ST SE
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:
98802-9250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-670-8423
Provider Business Practice Location Address Fax Number:
509-886-3207
Provider Enumeration Date:
01/22/2007