Provider First Line Business Practice Location Address:
5105 E 3RD 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:
99212-0725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-228-1313
Provider Business Practice Location Address Fax Number:
509-535-4290
Provider Enumeration Date:
01/08/2007