Provider First Line Business Practice Location Address:
9507 N DIVISION ST
Provider Second Line Business Practice Location Address:
THE HOLLAND BUILDING, SUITE A
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-1248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-466-6632
Provider Business Practice Location Address Fax Number:
509-466-0117
Provider Enumeration Date:
01/08/2006