Provider First Line Business Practice Location Address:
1008 S 38TH 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:
98902-3953
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-1035
Provider Business Practice Location Address Fax Number:
509-225-2700
Provider Enumeration Date:
10/01/2009