Provider First Line Business Practice Location Address:
700 E MOUNTAIN VIEW AVE STE 502
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-4802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-925-8500
Provider Business Practice Location Address Fax Number:
509-962-3744
Provider Enumeration Date:
10/03/2006