Provider First Line Business Practice Location Address:
1616 S CLINTON 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:
99216-0420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-824-3229
Provider Business Practice Location Address Fax Number:
509-323-1607
Provider Enumeration Date:
01/04/2010