Provider First Line Business Practice Location Address:
1502 N VERCLER 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:
99216-1078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
95-444-8200
Provider Business Practice Location Address Fax Number:
509-489-0686
Provider Enumeration Date:
11/17/2005