Provider First Line Business Practice Location Address:
1220 S 1ST ST
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:
98901-3502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-870-3673
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/25/2024