Provider First Line Business Practice Location Address:
4804 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:
98908-2850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-654-9962
Provider Business Practice Location Address Fax Number:
509-232-3330
Provider Enumeration Date:
05/25/2021