Provider First Line Business Practice Location Address:
2010 YAKIMA VALLEY HWY STE C1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYSIDE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98944-1289
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-840-0325
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2019