Provider First Line Business Practice Location Address:
1209 S 22ND AVE
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:
98902-5116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-594-2732
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2021