Provider First Line Business Practice Location Address:
230 GRANT RD 3-325
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST WENATCHEE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-782-5030
Provider Business Practice Location Address Fax Number:
509-241-9247
Provider Enumeration Date:
05/14/2013