Provider First Line Business Practice Location Address:
303 E D ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98901-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-248-0992
Provider Business Practice Location Address Fax Number:
509-575-8577
Provider Enumeration Date:
07/19/2007