Provider First Line Business Practice Location Address:
247 N 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:
98801-2104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-888-0988
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2016