Individual
THOMAS GLENNON DORLAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 N EMERSON AVE, WENATCHEE, WA 98801-6619
(509) 663-5420
Mailing address
1023 W PARK ST, WENATCHEE, WA 98801-3626
(509) 387-1852
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 60166075
WA
Other
Enumeration date
08/08/2010
Last updated
08/08/2010
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