Provider First Line Business Practice Location Address:
10010 N. DIVISION 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:
99218-3803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-466-2587
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2006