Provider First Line Business Practice Location Address:
322 W NORTH RIVER DR
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:
99201-3208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-327-2019
Provider Business Practice Location Address Fax Number:
775-327-2006
Provider Enumeration Date:
11/06/2006