Provider First Line Business Practice Location Address:
33 S 2ND 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:
98902-3414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-575-2885
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/08/2012