Provider First Line Business Practice Location Address:
PO BOX 959
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:
98907-0959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-731-0944
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/14/2024