Provider First Line Business Practice Location Address:
326 N MILLER ST
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:
98801-1906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-667-0679
Provider Business Practice Location Address Fax Number:
509-663-0441
Provider Enumeration Date:
08/19/2011