Provider First Line Business Practice Location Address:
5802 SUMMITVIEW AVE STE 190
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:
98908-3073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-5126
Provider Business Practice Location Address Fax Number:
509-965-5129
Provider Enumeration Date:
01/30/2014