Provider First Line Business Practice Location Address:
3023 OLD NACHES HWY
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:
98908-8900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-370-2712
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2023