Provider First Line Business Practice Location Address:
217 S 12TH 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:
98902-3110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-249-0300
Provider Business Practice Location Address Fax Number:
509-249-2971
Provider Enumeration Date:
09/15/2006