Provider First Line Business Practice Location Address:
120 S 3RD 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:
98901-2875
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-853-4134
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2018