Provider First Line Business Practice Location Address:
1723 S RAY 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:
99223-3832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-368-9537
Provider Business Practice Location Address Fax Number:
509-536-4744
Provider Enumeration Date:
04/09/2010