Provider First Line Business Practice Location Address:
1111 W. YAKIMA 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-452-1403
Provider Business Practice Location Address Fax Number:
509-452-1532
Provider Enumeration Date:
07/23/2006