Provider First Line Business Practice Location Address:
6101 SUMMITVIEW AVE STE 200
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:
98908-3028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-902-8857
Provider Business Practice Location Address Fax Number:
509-902-8855
Provider Enumeration Date:
07/29/2020