Provider First Line Business Practice Location Address:
640 SOUTH MISSION STREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-6761
Provider Business Practice Location Address Fax Number:
360-795-6224
Provider Enumeration Date:
05/04/2011