Provider First Line Business Practice Location Address:
108 B RAILROAD AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KITTITAS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-968-9545
Provider Business Practice Location Address Fax Number:
509-962-3013
Provider Enumeration Date:
01/04/2007