Provider First Line Business Practice Location Address:
100 E DALKE 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:
99208-1006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-484-3553
Provider Business Practice Location Address Fax Number:
509-484-3585
Provider Enumeration Date:
12/27/2006