Provider First Line Business Practice Location Address:
12B N UNIVERSITY RD
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:
99206-5205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-818-0086
Provider Business Practice Location Address Fax Number:
509-606-0439
Provider Enumeration Date:
12/08/2010