Provider First Line Business Practice Location Address:
1608 S 24TH AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-5719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-388-2270
Provider Business Practice Location Address Fax Number:
509-320-4109
Provider Enumeration Date:
01/30/2014