Provider First Line Business Practice Location Address:
201 N 24TH 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:
98902-2365
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-731-8671
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2025