Provider First Line Business Practice Location Address:
2812 TERRACE HEIGHTS DR STE 8
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:
98901-1439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-480-2106
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/31/2009