Provider First Line Business Practice Location Address:
16528 E DESMET CT
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:
99216-3522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-8820
Provider Business Practice Location Address Fax Number:
509-838-4978
Provider Enumeration Date:
05/10/2006