Provider First Line Business Practice Location Address:
1101 N 16TH AVE
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-1300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-654-9899
Provider Business Practice Location Address Fax Number:
509-697-9399
Provider Enumeration Date:
06/09/2011