Provider First Line Business Practice Location Address:
1337 S GRAND BLVD
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:
99202-1136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-1228
Provider Business Practice Location Address Fax Number:
509-838-0277
Provider Enumeration Date:
09/03/2009