Provider First Line Business Practice Location Address:
13818 W WHITE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99224-9735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-979-0001
Provider Business Practice Location Address Fax Number:
509-344-1100
Provider Enumeration Date:
04/03/2014