Provider First Line Business Practice Location Address:
6101 SUMMITVIEW AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-3048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-573-3530
Provider Business Practice Location Address Fax Number:
509-573-3535
Provider Enumeration Date:
06/22/2006