Provider First Line Business Practice Location Address:
103 PALOUSE ST STE 16
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:
98801-2251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-423-4480
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/01/2024