Provider First Line Business Practice Location Address:
402 E YAKIMA AVE
Provider Second Line Business Practice Location Address:
#330
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98901-2755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-4611
Provider Business Practice Location Address Fax Number:
509-454-3295
Provider Enumeration Date:
10/26/2006