Provider First Line Business Practice Location Address:
1450 N 16TH AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-1381
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-574-5000
Provider Business Practice Location Address Fax Number:
509-249-0035
Provider Enumeration Date:
09/21/2011