Provider First Line Business Practice Location Address:
408 NORTH 55TH 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:
98908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-972-0965
Provider Business Practice Location Address Fax Number:
509-972-0965
Provider Enumeration Date:
03/31/2008