Provider First Line Business Practice Location Address:
216 N 40TH AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-2947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-4526
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2022