Provider First Line Business Practice Location Address:
3502 SOUTH MCDONALD ROAD
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-979-4140
Provider Business Practice Location Address Fax Number:
509-565-4326
Provider Enumeration Date:
07/08/2005