Provider First Line Business Practice Location Address:
120 N 50TH 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:
98908-2800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-854-4120
Provider Business Practice Location Address Fax Number:
888-375-6238
Provider Enumeration Date:
01/09/2021