Provider First Line Business Practice Location Address:
524 S UNIVERSITY RD
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:
99206-5557
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-442-2274
Provider Business Practice Location Address Fax Number:
509-892-3886
Provider Enumeration Date:
03/15/2007