Provider First Line Business Practice Location Address:
3402 W WASHINGTON AVE
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98903-1172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-469-9537
Provider Business Practice Location Address Fax Number:
509-469-9578
Provider Enumeration Date:
03/08/2010