Provider First Line Business Practice Location Address:
2310 N. CHERRY ST.
Provider Second Line Business Practice Location Address:
SUITE 200
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-991-3054
Provider Business Practice Location Address Fax Number:
509-926-4669
Provider Enumeration Date:
08/13/2009