Provider First Line Business Practice Location Address:
9803 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:
99206-3645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-496-8810
Provider Business Practice Location Address Fax Number:
509-474-9857
Provider Enumeration Date:
01/18/2017