Provider First Line Business Practice Location Address:
4702 SUMMITVIEW AVE STE 102
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-571-1300
Provider Business Practice Location Address Fax Number:
877-334-1891
Provider Enumeration Date:
04/03/2018