Provider First Line Business Practice Location Address:
1703 GRANT ST
Provider Second Line Business Practice Location Address:
# 1
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-5280
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-453-1231
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2008