Provider First Line Business Practice Location Address:
12905 E SPRAGUE 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:
99216-0731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-922-0303
Provider Business Practice Location Address Fax Number:
509-922-0657
Provider Enumeration Date:
01/22/2007