Provider First Line Business Practice Location Address:
12314 E BROADWAY AVE
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:
99216-1929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-598-8848
Provider Business Practice Location Address Fax Number:
509-309-3811
Provider Enumeration Date:
04/14/2008