Provider First Line Business Practice Location Address:
1020 S 40TH AVE STE F
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:
98908-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-7668
Provider Business Practice Location Address Fax Number:
509-965-7520
Provider Enumeration Date:
07/12/2011