Provider First Line Business Practice Location Address:
528 W SINTO AVE
Provider Second Line Business Practice Location Address:
ANNEX
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-981-2625
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2007