Provider First Line Business Practice Location Address:
402 E YAKIMA AVE STE 450
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:
98901-5413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-833-5443
Provider Business Practice Location Address Fax Number:
509-457-2756
Provider Enumeration Date:
02/22/2012