Provider First Line Business Practice Location Address:
505 N. ARGONNE RD.
Provider Second Line Business Practice Location Address:
SUITE B108
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-926-9911
Provider Business Practice Location Address Fax Number:
509-926-9988
Provider Enumeration Date:
05/15/2006