Provider First Line Business Practice Location Address:
1418 N DICK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99212-2504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-758-2928
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2008