Provider First Line Business Practice Location Address:
1399 NAT WASHINGTON WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98823-2629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-764-2999
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2006