Provider First Line Business Practice Location Address:
208 N 3RD AVE
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:
98902-2632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-521-0995
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/21/2007