Provider First Line Business Practice Location Address:
1511 ELMWOOD ST
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:
98801-7504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-808-0874
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/05/2024