Provider First Line Business Practice Location Address:
1001 SUMMITVIEW AVE STE 3
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:
98902-3023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-453-0300
Provider Business Practice Location Address Fax Number:
509-452-0890
Provider Enumeration Date:
08/12/2011