Provider First Line Business Practice Location Address:
510 S 9TH ST
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:
98901-4617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-573-2329
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2017