Provider First Line Business Practice Location Address:
111 S 11TH AVE STE 320
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:
98902-3273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-454-8888
Provider Business Practice Location Address Fax Number:
509-453-0061
Provider Enumeration Date:
05/09/2006