Provider First Line Business Practice Location Address:
826 E 34TH 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:
99203-3146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-686-1931
Provider Business Practice Location Address Fax Number:
208-686-8052
Provider Enumeration Date:
11/11/2008