Provider First Line Business Practice Location Address:
1224 N ASH 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:
99201-2802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-477-1511
Provider Business Practice Location Address Fax Number:
509-477-1635
Provider Enumeration Date:
07/18/2012