Provider First Line Business Practice Location Address:
1001 SUMMITVIEW 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:
98902-3023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-452-0890
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/19/2006