Provider First Line Business Practice Location Address:
2309 W. DOLARWAY RD
Provider Second Line Business Practice Location Address:
STE. 2
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-8087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-968-5066
Provider Business Practice Location Address Fax Number:
509-968-5057
Provider Enumeration Date:
12/21/2016