Provider First Line Business Practice Location Address:
602 N. 39TH AVE.
Provider Second Line Business Practice Location Address:
STE#200
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-452-0279
Provider Business Practice Location Address Fax Number:
509-457-6306
Provider Enumeration Date:
11/03/2006