Provider First Line Business Practice Location Address:
5601 E SPRAGUE 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:
99212-0826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-842-0033
Provider Business Practice Location Address Fax Number:
509-842-0034
Provider Enumeration Date:
03/19/2015