Provider First Line Business Practice Location Address:
3801 SUMMITVIEW 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:
98902-2794
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-965-5240
Provider Business Practice Location Address Fax Number:
877-282-1880
Provider Enumeration Date:
03/03/2011