Provider First Line Business Practice Location Address:
9106 W RUTTER PKWY
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:
99208-9210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-418-4248
Provider Business Practice Location Address Fax Number:
509-418-0402
Provider Enumeration Date:
06/12/2013