Provider First Line Business Practice Location Address:
2312 N CHERRY ST STE 100
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:
99216-2852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-863-6174
Provider Business Practice Location Address Fax Number:
509-588-0614
Provider Enumeration Date:
02/17/2011