Provider First Line Business Practice Location Address:
9720 N NEVADA
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:
99218-3412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-464-2273
Provider Business Practice Location Address Fax Number:
509-242-1954
Provider Enumeration Date:
01/06/2006