Provider First Line Business Practice Location Address:
505 N 4TH ST
Provider Second Line Business Practice Location Address:
SUITE # 7
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98901-2435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-5310
Provider Business Practice Location Address Fax Number:
509-210-2436
Provider Enumeration Date:
02/07/2007