Provider First Line Business Practice Location Address:
6602 APPLEVIEW RD
Provider Second Line Business Practice Location Address:
ROOM1
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-1394
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-895-4970
Provider Business Practice Location Address Fax Number:
509-965-3407
Provider Enumeration Date:
04/29/2009