Provider First Line Business Practice Location Address:
3026 S GRAND BLVD
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:
99203-2560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-7427
Provider Business Practice Location Address Fax Number:
888-343-6937
Provider Enumeration Date:
05/12/2006