Provider First Line Business Practice Location Address:
539 S CHELAN 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:
98801-2977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-423-0123
Provider Business Practice Location Address Fax Number:
877-227-1329
Provider Enumeration Date:
03/29/2016