Provider First Line Business Practice Location Address:
1121 N ARGONNE RD
Provider Second Line Business Practice Location Address:
SUITE B210
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99212-2686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-1090
Provider Business Practice Location Address Fax Number:
855-777-2735
Provider Enumeration Date:
01/31/2014