Provider First Line Business Practice Location Address:
2205 W DOLARWAY RD STE 1
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:
98926-8241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-925-2211
Provider Business Practice Location Address Fax Number:
833-340-0442
Provider Enumeration Date:
08/28/2019