Provider First Line Business Practice Location Address:
14910 FISK RD
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:
98908-8077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-972-2047
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2007