Provider First Line Business Practice Location Address:
12410 E SINTO AVE STE 101
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:
99216-2258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-789-2956
Provider Business Practice Location Address Fax Number:
509-789-2976
Provider Enumeration Date:
02/14/2007