Provider First Line Business Practice Location Address:
917 PITCHER ST
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:
98901-3063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-8554
Provider Business Practice Location Address Fax Number:
509-225-4682
Provider Enumeration Date:
06/19/2007