Provider First Line Business Practice Location Address:
801 EASTMONT AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98802-7665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-886-2345
Provider Business Practice Location Address Fax Number:
509-886-2611
Provider Enumeration Date:
12/22/2011