Provider First Line Business Practice Location Address:
4202 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:
98908-2928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-966-4700
Provider Business Practice Location Address Fax Number:
509-966-4701
Provider Enumeration Date:
05/14/2007