Provider First Line Business Practice Location Address:
12802 E SALTESE 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:
99216-0361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-7882
Provider Business Practice Location Address Fax Number:
509-928-7866
Provider Enumeration Date:
08/13/2012