Provider First Line Business Practice Location Address:
411 S 12TH AVE STE 2
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:
98902-3109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-969-3908
Provider Business Practice Location Address Fax Number:
509-873-7188
Provider Enumeration Date:
05/23/2024