Provider First Line Business Practice Location Address:
3907 SUMMITVIEW AVE
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-2716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-966-1640
Provider Business Practice Location Address Fax Number:
509-469-1905
Provider Enumeration Date:
01/12/2010