Provider First Line Business Practice Location Address:
1111 N 35TH AVE, SUITE 100
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:
98902-1622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-248-0933
Provider Business Practice Location Address Fax Number:
509-575-4763
Provider Enumeration Date:
09/05/2019