Provider First Line Business Practice Location Address:
3405 W BIRCHFIELD RD
Provider Second Line Business Practice Location Address:
E
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98901-9571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-575-0204
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2009