Provider First Line Business Practice Location Address:
1005 W WALNUT ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-3360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-575-1000
Provider Business Practice Location Address Fax Number:
507-575-1197
Provider Enumeration Date:
08/21/2006