Provider First Line Business Practice Location Address:
13414 E SPRAGUE 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:
99216-0848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-1744
Provider Business Practice Location Address Fax Number:
509-924-9724
Provider Enumeration Date:
06/05/2006