Provider First Line Business Practice Location Address:
4067 BLUE ROCK DR NE
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:
98802-9000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-387-5212
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/23/2021