Provider First Line Business Practice Location Address:
2206 SOUTH WALL ST.
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:
99203-1938
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-7253
Provider Business Practice Location Address Fax Number:
509-838-7196
Provider Enumeration Date:
10/31/2006