Provider First Line Business Practice Location Address:
330 KING ST STE 7
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:
98801-2857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-751-5220
Provider Business Practice Location Address Fax Number:
888-416-2221
Provider Enumeration Date:
10/05/2020