Provider First Line Business Practice Location Address:
1310 S 6TH AVE
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:
98902-5542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-833-6524
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2009