Provider First Line Business Practice Location Address:
722 E UNIVERSITY WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-2947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-962-1553
Provider Business Practice Location Address Fax Number:
888-538-7694
Provider Enumeration Date:
09/09/2022