Provider First Line Business Practice Location Address:
111 S 11TH AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-3242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-454-6545
Provider Business Practice Location Address Fax Number:
509-454-6544
Provider Enumeration Date:
03/07/2011