Provider First Line Business Practice Location Address:
2656 E 29TH
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:
99223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-535-7791
Provider Business Practice Location Address Fax Number:
509-535-1833
Provider Enumeration Date:
08/23/2006