Provider First Line Business Practice Location Address:
1414 N HOUK RD
Provider Second Line Business Practice Location Address:
STE. 100
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-1097
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-4501
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2007