Provider First Line Business Practice Location Address:
201 E LINCOLN AVE STE 100
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:
98901-2348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-5653
Provider Business Practice Location Address Fax Number:
509-457-3107
Provider Enumeration Date:
10/12/2018