Provider First Line Business Practice Location Address:
602 E NOB HILL BLVD
Provider Second Line Business Practice Location Address:
CHS
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98901-3534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-6540
Provider Business Practice Location Address Fax Number:
509-453-6144
Provider Enumeration Date:
01/10/2008