Provider First Line Business Practice Location Address:
1111 N 35TH AVE STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-1622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-969-6214
Provider Business Practice Location Address Fax Number:
509-420-9357
Provider Enumeration Date:
05/22/2007