Provider First Line Business Practice Location Address:
102 S NACHES 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:
98901-2947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-834-2098
Provider Business Practice Location Address Fax Number:
509-454-4115
Provider Enumeration Date:
05/21/2007