Provider First Line Business Practice Location Address:
9212 E MONTGOMERY AVE
Provider Second Line Business Practice Location Address:
#103
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99206-4239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-922-0855
Provider Business Practice Location Address Fax Number:
509-921-0050
Provider Enumeration Date:
11/21/2006