Provider First Line Business Practice Location Address:
601 N 39TH ST
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:
98901-1222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-833-1966
Provider Business Practice Location Address Fax Number:
509-577-0635
Provider Enumeration Date:
02/23/2017