Provider First Line Business Practice Location Address:
9212 N K 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:
99208-6563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-995-0721
Provider Business Practice Location Address Fax Number:
509-471-1948
Provider Enumeration Date:
01/12/2007