Provider First Line Business Practice Location Address:
4720 E WILLOW SPRINGS RD
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:
99223-9607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-443-6132
Provider Business Practice Location Address Fax Number:
509-448-1540
Provider Enumeration Date:
06/27/2007