Provider First Line Business Practice Location Address:
8 E WASHINGTON AVE # 107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98903-1683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-269-0405
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/29/2008