Provider First Line Business Practice Location Address:
2510 BIRCHFIELD RD
Provider Second Line Business Practice Location Address:
UNIT 1
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98901-9534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-494-9170
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2007