Provider First Line Business Practice Location Address:
7406 E SPRAGUE AVE STE 9
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:
99212-0681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-998-1089
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2007