Provider First Line Business Practice Location Address:
6 S 2ND ST STE 200
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:
98901-2629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-315-4784
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2009