Provider First Line Business Practice Location Address:
360 ROCK ISLAND RD
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:
509-664-0529
Provider Business Practice Location Address Fax Number:
509-667-8741
Provider Enumeration Date:
12/20/2006