Provider First Line Business Practice Location Address:
413 N 20TH AVE 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:
98902-1807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-8151
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2018