Provider First Line Business Practice Location Address:
6 S 2ND ST
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:
98901-2632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-517-6782
Provider Business Practice Location Address Fax Number:
509-223-4194
Provider Enumeration Date:
06/27/2017