Provider First Line Business Practice Location Address:
315 N 2ND ST
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:
98901-2334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-469-9366
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2022