Provider First Line Business Practice Location Address:
321 W HASTINGS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-2814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-323-1751
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2008