Provider First Line Business Practice Location Address:
15701 E SPRAGUE AVE STE C
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:
99037-5019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-599-6580
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/18/2010