Provider First Line Business Practice Location Address:
112 S ELLIOTT 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:
98801-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-663-7117
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/15/2020