Provider First Line Business Practice Location Address:
10618 E SPRAGUE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206-3634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-241-3327
Provider Business Practice Location Address Fax Number:
208-772-2313
Provider Enumeration Date:
06/18/2014