Provider First Line Business Practice Location Address:
3905 SUMMITVIEW AVE
Provider Second Line Business Practice Location Address:
SUITE 200
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:
509-965-6751
Provider Business Practice Location Address Fax Number:
509-965-9868
Provider Enumeration Date:
03/19/2007