Provider First Line Business Practice Location Address:
1228 HILL ST
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:
98801-8226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-470-6766
Provider Business Practice Location Address Fax Number:
509-470-6766
Provider Enumeration Date:
05/15/2014