Provider First Line Business Practice Location Address:
11916 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:
99206-5143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-1325
Provider Business Practice Location Address Fax Number:
509-926-2688
Provider Enumeration Date:
08/31/2016