Provider First Line Business Practice Location Address:
130 E 3RD 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:
99202-1410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-4246
Provider Business Practice Location Address Fax Number:
509-444-4371
Provider Enumeration Date:
03/19/2007