Provider First Line Business Practice Location Address:
524 S UNIVERSITY RD
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:
99206-5557
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-290-0591
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2010