Provider First Line Business Practice Location Address:
11703 E SPRAGUE AVE STE C3
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:
509-921-6560
Provider Business Practice Location Address Fax Number:
509-921-6551
Provider Enumeration Date:
08/10/2006