Provider First Line Business Practice Location Address:
1711 LEXINGTON PL
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:
98801-1762
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-264-5003
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2025