Provider First Line Business Practice Location Address:
307 S 3RD 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:
98902-3538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-969-8789
Provider Business Practice Location Address Fax Number:
509-469-9258
Provider Enumeration Date:
11/01/2006