Provider First Line Business Practice Location Address:
220 NAT WASHINGTON WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98823-1982
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-754-3330
Provider Business Practice Location Address Fax Number:
509-754-4809
Provider Enumeration Date:
11/23/2005