Provider First Line Business Practice Location Address:
1724 W FRANCIS 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:
99205-6833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-325-3431
Provider Business Practice Location Address Fax Number:
509-328-3229
Provider Enumeration Date:
10/10/2005