Provider First Line Business Practice Location Address:
103 PALOUSE ST STE 15
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:
98801-2251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-393-1878
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2020