Provider First Line Business Practice Location Address:
1802 N MONROE ST
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:
99205-4528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-343-6252
Provider Business Practice Location Address Fax Number:
509-343-6251
Provider Enumeration Date:
08/04/2006