Provider First Line Business Practice Location Address:
502 W NOB HILL BLVD UNIT 1
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:
98902-5500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-249-0011
Provider Business Practice Location Address Fax Number:
509-249-0077
Provider Enumeration Date:
09/02/2006