Provider First Line Business Practice Location Address:
2508 W NOB HILL BLVD
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:
98902-5104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-966-5555
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2013