Provider First Line Business Practice Location Address:
1209 N 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-999-2535
Provider Business Practice Location Address Fax Number:
509-847-0162
Provider Enumeration Date:
10/12/2011