Provider First Line Business Practice Location Address:
625 OKANOGAN 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:
98801-6409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-1636
Provider Business Practice Location Address Fax Number:
509-662-8690
Provider Enumeration Date:
09/14/2005