Provider First Line Business Practice Location Address:
624 E FRONT AVE
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:
99202-2139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-626-9904
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2006