Provider First Line Business Practice Location Address:
701 E 10TH 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:
99202-2412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-322-6495
Provider Business Practice Location Address Fax Number:
509-534-1071
Provider Enumeration Date:
01/30/2007