Provider First Line Business Practice Location Address:
3800 SUMMITVIEW AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
YAKIMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98902-2715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-972-1194
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2016