Provider First Line Business Practice Location Address:
1400 SUMMITVIEW AVE STE 103
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:
98902-2965
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-317-2497
Provider Business Practice Location Address Fax Number:
509-225-7449
Provider Enumeration Date:
06/11/2008