Provider First Line Business Practice Location Address:
719 N 39 AVE
Provider Second Line Business Practice Location Address:
#100
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-453-3610
Provider Business Practice Location Address Fax Number:
509-453-2411
Provider Enumeration Date:
11/03/2006