Provider First Line Business Practice Location Address:
111 UNIVERSITY PKWY STE 104
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:
98901-1448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-767-6447
Provider Business Practice Location Address Fax Number:
509-225-9415
Provider Enumeration Date:
10/23/2014