Provider First Line Business Practice Location Address:
4304 W CHESTNUT 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:
98908-3257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-823-4200
Provider Business Practice Location Address Fax Number:
509-823-4200
Provider Enumeration Date:
02/07/2019