Provider First Line Business Practice Location Address:
18211 E APPLEWAY 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:
99016-9564
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-926-1551
Provider Business Practice Location Address Fax Number:
509-926-1661
Provider Enumeration Date:
04/11/2008