Provider First Line Business Practice Location Address:
1215 N MCDONALD ROAD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-926-1559
Provider Business Practice Location Address Fax Number:
509-926-1550
Provider Enumeration Date:
11/08/2006