Provider First Line Business Practice Location Address:
13701 E SPRAGUE 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:
99216-0811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-922-5585
Provider Business Practice Location Address Fax Number:
509-927-7336
Provider Enumeration Date:
04/14/2016