Provider First Line Business Practice Location Address:
719 N 39TH AVE STE 102
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:
98902-6302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-4532
Provider Business Practice Location Address Fax Number:
509-457-0175
Provider Enumeration Date:
07/25/2013