Provider First Line Business Practice Location Address:
1137 W GARLAND 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:
99205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-5143
Provider Business Practice Location Address Fax Number:
509-327-9813
Provider Enumeration Date:
07/17/2008