Provider First Line Business Practice Location Address:
1215 N MCDONALD RD
Provider Second Line Business Practice Location Address:
SUITE #201
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-1557
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-926-1559
Provider Business Practice Location Address Fax Number:
509-926-1550
Provider Enumeration Date:
10/29/2015