Provider First Line Business Practice Location Address:
707 W 5TH 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:
99204-2739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-1797
Provider Business Practice Location Address Fax Number:
509-456-5345
Provider Enumeration Date:
02/23/2007