Provider First Line Business Practice Location Address:
1118 S PERRY 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:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-534-2232
Provider Business Practice Location Address Fax Number:
509-532-8636
Provider Enumeration Date:
08/10/2006