Provider First Line Business Practice Location Address:
205 N 5TH 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:
98902-2643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-453-8833
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/09/2023