Provider First Line Business Practice Location Address:
121 N 50TH 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:
98908-2862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-9451
Provider Business Practice Location Address Fax Number:
509-965-1922
Provider Enumeration Date:
02/16/2006