Provider First Line Business Practice Location Address:
124 E PACIFIC 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:
99202-1518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-3314
Provider Business Practice Location Address Fax Number:
509-747-0952
Provider Enumeration Date:
08/01/2007