Provider First Line Business Practice Location Address:
3601 W WASHINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98903-1164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-249-0120
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2015