Provider First Line Business Practice Location Address:
2802 W NOB HILL BLVD # A
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:
98902-4982
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-576-0600
Provider Business Practice Location Address Fax Number:
509-576-0602
Provider Enumeration Date:
07/03/2006