Provider First Line Business Practice Location Address:
611 W A 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:
98902-2605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-961-6336
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2024