Provider First Line Business Practice Location Address:
402 N 4TH ST
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98901-2470
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-453-9387
Provider Business Practice Location Address Fax Number:
509-453-2716
Provider Enumeration Date:
04/27/2006