Provider First Line Business Practice Location Address:
918 E MEAD 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:
98903-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-836-4161
Provider Business Practice Location Address Fax Number:
509-837-0450
Provider Enumeration Date:
04/27/2006