Provider First Line Business Practice Location Address:
6 SOUTH 2ND STREET
Provider Second Line Business Practice Location Address:
SUITE 1008
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-453-4697
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2008