Provider First Line Business Practice Location Address:
2426 S DISHMAN MICA RD STE 3
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:
99206-6409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-953-4149
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2017