Provider First Line Business Practice Location Address:
2109 W DOLARWAY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-9367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-968-5086
Provider Business Practice Location Address Fax Number:
844-755-6412
Provider Enumeration Date:
10/05/2021