Provider First Line Business Practice Location Address:
20 N. EVERGREEN RD
Provider Second Line Business Practice Location Address:
STE 101
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-926-1500
Provider Business Practice Location Address Fax Number:
509-892-0200
Provider Enumeration Date:
09/14/2006