Provider First Line Business Practice Location Address:
520 E NORTH FOOTHILLS DR
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:
99207-2164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-822-6897
Provider Business Practice Location Address Fax Number:
509-570-0443
Provider Enumeration Date:
12/20/2006