Provider First Line Business Practice Location Address:
3901 KERN WAY STE 102
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:
98902-7804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-985-6583
Provider Business Practice Location Address Fax Number:
509-895-7452
Provider Enumeration Date:
04/12/2021