Provider First Line Business Practice Location Address:
307 S 12TH AVE STE 12
Provider Second Line Business Practice Location Address:
SUITE 12
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-3143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-575-7500
Provider Business Practice Location Address Fax Number:
509-575-0333
Provider Enumeration Date:
01/05/2009