Provider First Line Business Practice Location Address:
1200 CHESTERLY DR 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:
98902-7339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-426-4790
Provider Business Practice Location Address Fax Number:
509-554-5597
Provider Enumeration Date:
02/22/2012