Provider First Line Business Practice Location Address:
121 N 52ND 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:
98908-3138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-833-5481
Provider Business Practice Location Address Fax Number:
855-246-2166
Provider Enumeration Date:
07/09/2024