Provider First Line Business Practice Location Address:
399 E YAKIMA AVE STE 183
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:
98901-4519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-225-4772
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2017