Provider First Line Business Practice Location Address:
11703 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:
99206-6128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-435-0481
Provider Business Practice Location Address Fax Number:
509-888-3063
Provider Enumeration Date:
06/02/2023