Provider First Line Business Practice Location Address:
110 SOUTH 9TH 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:
98901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-969-1951
Provider Business Practice Location Address Fax Number:
509-577-0147
Provider Enumeration Date:
09/19/2006