Provider First Line Business Practice Location Address:
1510 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:
98902-2951
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-453-5726
Provider Business Practice Location Address Fax Number:
509-453-7899
Provider Enumeration Date:
10/11/2006