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:
509-574-3236
Provider Business Practice Location Address Fax Number:
509-574-3210
Provider Enumeration Date:
04/24/2006