Provider First Line Business Practice Location Address:
1005 W WALNUT ST 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:
98902-3360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-454-6545
Provider Business Practice Location Address Fax Number:
509-454-6544
Provider Enumeration Date:
11/14/2017