Provider First Line Business Practice Location Address:
3150 E 27TH AVE
Provider Second Line Business Practice Location Address:
# 100
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99223-4919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-828-4561
Provider Business Practice Location Address Fax Number:
509-228-8210
Provider Enumeration Date:
08/31/2006