Provider First Line Business Practice Location Address:
5005 SQUILCHUCK RD
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:
98801-9498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-881-0868
Provider Business Practice Location Address Fax Number:
509-470-6691
Provider Enumeration Date:
04/04/2013