Provider First Line Business Practice Location Address:
3700 FAIRBANKS AVE STE 200
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:
98902-6325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-5009
Provider Business Practice Location Address Fax Number:
509-457-5983
Provider Enumeration Date:
03/19/2014