Provider First Line Business Practice Location Address:
603 N OAK 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:
99201-1836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-795-4910
Provider Business Practice Location Address Fax Number:
509-315-2244
Provider Enumeration Date:
10/24/2006