Provider First Line Business Practice Location Address:
610 N MISSION ST
Provider Second Line Business Practice Location Address:
SUITE B4
Provider Business Practice Location Address City Name:
WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98801-2065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-9624
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2014