Provider First Line Business Practice Location Address:
5600 E 8TH AVE
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:
99212-0220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-533-6910
Provider Business Practice Location Address Fax Number:
509-535-2863
Provider Enumeration Date:
04/15/2019