Provider First Line Business Practice Location Address:
400 W VIOLA AVE
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:
98902-5609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-573-5994
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2013