Provider First Line Business Practice Location Address:
9329 E MONTGOMERY AVE
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:
99206-4295
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-343-3379
Provider Business Practice Location Address Fax Number:
509-242-1764
Provider Enumeration Date:
09/20/2006