Provider First Line Business Practice Location Address:
5100 W NOB HILL BLVD
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-972-7862
Provider Business Practice Location Address Fax Number:
509-972-4199
Provider Enumeration Date:
03/22/2007