Provider First Line Business Practice Location Address:
505 N ARGONNE RD STE B101
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-701-0935
Provider Business Practice Location Address Fax Number:
509-497-2140
Provider Enumeration Date:
07/01/2014