Provider First Line Business Practice Location Address:
2302 W DOLARWAY RD STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-8081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-730-2291
Provider Business Practice Location Address Fax Number:
509-593-4676
Provider Enumeration Date:
12/08/2006