Provider First Line Business Practice Location Address:
721 S LINCOLN ST
Provider Second Line Business Practice Location Address:
A2
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-302-9988
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/21/2010