Provider First Line Business Practice Location Address:
3408 W NOB HILL BLVD
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:
98902-4731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-5050
Provider Business Practice Location Address Fax Number:
509-457-4700
Provider Enumeration Date:
06/05/2011