Provider First Line Business Practice Location Address:
930 N MULLAN RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206-4004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-891-7770
Provider Business Practice Location Address Fax Number:
509-891-7773
Provider Enumeration Date:
05/22/2007