Provider First Line Business Practice Location Address:
811 W YAKIMA AVE STE 104
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:
98902-3088
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-367-6066
Provider Business Practice Location Address Fax Number:
509-367-6190
Provider Enumeration Date:
03/14/2017