Provider First Line Business Practice Location Address:
1215 N MCDONALD RD
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-1048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-2866
Provider Business Practice Location Address Fax Number:
509-924-8311
Provider Enumeration Date:
04/10/2007