Provider First Line Business Practice Location Address:
102 N EMERSON 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:
98801-2146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-663-4875
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2011