Provider First Line Business Practice Location Address:
1015 SOUTH 40TH 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-3115
Provider Business Practice Location Address Fax Number:
509-966-5371
Provider Enumeration Date:
11/01/2006