Provider First Line Business Practice Location Address:
12623 E SPRAGUE AVE STE 6
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:
99216-0764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-674-5871
Provider Business Practice Location Address Fax Number:
509-232-5795
Provider Enumeration Date:
09/25/2006