Provider First Line Business Practice Location Address:
1109 W SPRUCE ST
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-952-8311
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/05/2015