Provider First Line Business Practice Location Address:
9723 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:
99206-3620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-0505
Provider Business Practice Location Address Fax Number:
509-928-0606
Provider Enumeration Date:
10/02/2006