Provider First Line Business Practice Location Address:
3907 CREEKSIDE LOOP 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:
98902-4879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-895-7535
Provider Business Practice Location Address Fax Number:
509-895-7355
Provider Enumeration Date:
05/02/2007