Provider First Line Business Practice Location Address:
421 S 47TH AVE STE C
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:
98908-3204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-969-9393
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2015