Provider First Line Business Practice Location Address:
1027 E 39TH AVE
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:
99203-3036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-939-0800
Provider Business Practice Location Address Fax Number:
509-747-7984
Provider Enumeration Date:
05/07/2007