Provider First Line Business Practice Location Address:
15701 E SPRAGUE AVE STE F
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:
99037-5019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-919-1471
Provider Business Practice Location Address Fax Number:
509-381-5382
Provider Enumeration Date:
04/20/2023