Provider First Line Business Practice Location Address:
6227 N 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:
99205-6548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-2291
Provider Business Practice Location Address Fax Number:
509-326-7469
Provider Enumeration Date:
08/23/2006