Provider First Line Business Practice Location Address:
406 S 82ND AVE
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:
98908-9763
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-910-2144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2007