Provider First Line Business Practice Location Address:
2010 YAKIMA VALLEY HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYSIDE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98944-1288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-839-2711
Provider Business Practice Location Address Fax Number:
509-839-4768
Provider Enumeration Date:
05/19/2011