Provider First Line Business Practice Location Address:
6201 SUMMITVIEW AVE
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-3019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-454-8850
Provider Business Practice Location Address Fax Number:
509-452-3293
Provider Enumeration Date:
05/31/2005