Provider First Line Business Practice Location Address:
208 E FRANCIS 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:
99208-1071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-7827
Provider Business Practice Location Address Fax Number:
509-489-7828
Provider Enumeration Date:
10/22/2010