Provider First Line Business Practice Location Address:
16201 E INDIANA AVE
Provider Second Line Business Practice Location Address:
5000
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-2830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-7271
Provider Business Practice Location Address Fax Number:
509-928-7802
Provider Enumeration Date:
08/21/2012