Provider First Line Business Practice Location Address:
606 N PINES RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206-6706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-927-9450
Provider Business Practice Location Address Fax Number:
927-928-8574
Provider Enumeration Date:
11/01/2006