Provider First Line Business Practice Location Address:
100 S CLEVELAND AVE
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:
98801-2605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-888-0773
Provider Business Practice Location Address Fax Number:
509-888-6751
Provider Enumeration Date:
05/12/2015