Provider First Line Business Practice Location Address:
905 S MONROE 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:
99204-3835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-8993
Provider Business Practice Location Address Fax Number:
509-455-9743
Provider Enumeration Date:
05/09/2007