Provider First Line Business Practice Location Address:
1201 W WASHINGTON AVE UNIT 83
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:
98903-1262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-759-9553
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/02/2021