Provider First Line Business Practice Location Address:
2204 W NOB HILL BLVD STE B
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:
98902-6200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-453-4414
Provider Business Practice Location Address Fax Number:
509-457-8904
Provider Enumeration Date:
04/24/2021