Provider First Line Business Practice Location Address:
2802 W NOB HILL BLVD STE A
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:
98902-4982
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-627-6888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2016