Provider First Line Business Practice Location Address:
1912 E HOFFMAN AVE
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:
99207-4219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-475-0065
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/21/2013