Provider First Line Business Practice Location Address:
603 S CHESTNUT ST
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:
98926-3875
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-933-8693
Provider Business Practice Location Address Fax Number:
509-933-8694
Provider Enumeration Date:
03/21/2023