Provider First Line Business Practice Location Address:
406 S. 30TH AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-248-7715
Provider Business Practice Location Address Fax Number:
509-248-2890
Provider Enumeration Date:
06/27/2006