Provider First Line Business Practice Location Address:
1050 N MILLER 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:
98801-1512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-665-7539
Provider Business Practice Location Address Fax Number:
509-665-3180
Provider Enumeration Date:
09/23/2011