Provider First Line Business Practice Location Address:
506 N 40TH AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98908-4330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-966-9884
Provider Business Practice Location Address Fax Number:
509-965-6137
Provider Enumeration Date:
06/29/2007