Provider First Line Business Practice Location Address:
122 N ARGONNE RD
Provider Second Line Business Practice Location Address:
STE 3
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99212-2550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-599-3063
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2008