Provider First Line Business Practice Location Address:
203 E SPRAGUE 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:
99202-1533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-443-4995
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2014