Provider First Line Business Practice Location Address:
16212 E INDIANA AVE
Provider Second Line Business Practice Location Address:
SUITE A
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-922-3333
Provider Business Practice Location Address Fax Number:
509-922-6533
Provider Enumeration Date:
06/03/2016