Provider First Line Business Practice Location Address:
1014 WALLA WALLA 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:
98801-1523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-201-2585
Provider Business Practice Location Address Fax Number:
509-663-3726
Provider Enumeration Date:
03/26/2018