Provider First Line Business Practice Location Address:
7527 N MARKET ST
Provider Second Line Business Practice Location Address:
B #1
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99217-7828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-8814
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2007