Provider First Line Business Practice Location Address:
200 E 4TH AVE
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:
98926-3126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-255-3150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/24/2024