Provider First Line Business Practice Location Address:
2410 TERRACE HEIGHTS DR STE B
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:
98901-1403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-966-0675
Provider Business Practice Location Address Fax Number:
509-823-4433
Provider Enumeration Date:
03/15/2023