Provider First Line Business Practice Location Address:
1110 N. 35TH 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:
98902-1622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-834-7050
Provider Business Practice Location Address Fax Number:
509-834-7051
Provider Enumeration Date:
06/03/2014