Provider First Line Business Practice Location Address:
2280 STATE ROUTE 821
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:
98901-8302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-457-0990
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2025