Provider First Line Business Practice Location Address:
6400 W NOB HILL BLVD
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:
98908-1929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-0541
Provider Business Practice Location Address Fax Number:
509-965-0895
Provider Enumeration Date:
11/16/2015