Provider First Line Business Practice Location Address:
12410 E SINTO AVE STE B
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:
99216-2280
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-2531
Provider Business Practice Location Address Fax Number:
509-755-6580
Provider Enumeration Date:
04/13/2006