Provider First Line Business Practice Location Address:
3910 SUMMITVIEW AVE STE 140
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:
98902-2780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-966-9672
Provider Business Practice Location Address Fax Number:
509-972-8324
Provider Enumeration Date:
03/01/2007