Provider First Line Business Practice Location Address:
210 S 11TH AVE STE 42
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:
98902-3221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-509-5790
Provider Business Practice Location Address Fax Number:
509-509-5791
Provider Enumeration Date:
12/19/2024