Provider First Line Business Practice Location Address:
9227 E MAIN 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:
99206-3768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-343-1116
Provider Business Practice Location Address Fax Number:
509-444-7806
Provider Enumeration Date:
11/01/2006