Provider First Line Business Practice Location Address:
7209 S. SOUTH MEADOWS 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:
99223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-994-5442
Provider Business Practice Location Address Fax Number:
509-448-8917
Provider Enumeration Date:
10/11/2005