Provider First Line Business Practice Location Address:
1420 N JEFFERSON 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:
99201-2607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-9107
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2007