Provider First Line Business Practice Location Address:
502 N 40TH AVE
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-4319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-574-8492
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2009