Provider First Line Business Practice Location Address:
306 N 27TH 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:
98902-2323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-575-0336
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006