Provider First Line Business Practice Location Address:
7302 W YAKIMA AVE
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:
98908-1596
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-388-1025
Provider Business Practice Location Address Fax Number:
509-388-1025
Provider Enumeration Date:
01/08/2007