Provider First Line Business Practice Location Address:
414 S UNIVERSITY 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:
99206-5555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-499-6704
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2007