Provider First Line Business Practice Location Address:
1807 N HUTCHINSON 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:
99212-2444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-456-7414
Provider Business Practice Location Address Fax Number:
509-624-0763
Provider Enumeration Date:
02/28/2006