Provider First Line Business Practice Location Address:
7204 E SPRAGUE AVE
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:
99212-0631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-928-9337
Provider Business Practice Location Address Fax Number:
509-928-9395
Provider Enumeration Date:
04/19/2007