Provider First Line Business Practice Location Address:
1014 N PINES RD
Provider Second Line Business Practice Location Address:
STE 203
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-926-8939
Provider Business Practice Location Address Fax Number:
509-926-1910
Provider Enumeration Date:
09/01/2006