Provider First Line Business Practice Location Address:
7200 W NOB HILL BLVD
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-1928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-388-6797
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2009