Provider First Line Business Practice Location Address:
3911 CASTLEVALE RD STE 301
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:
98902-7807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-966-7899
Provider Business Practice Location Address Fax Number:
509-225-6811
Provider Enumeration Date:
09/24/2007