Provider First Line Business Practice Location Address:
5200 W NOB HILL BLVD
Provider Second Line Business Practice Location Address:
#153
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-3778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-869-5894
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2007