Provider First Line Business Practice Location Address:
620 N ARGONNE RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99212-2792
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-8762
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/24/2006