Provider First Line Business Practice Location Address:
32 W 2ND 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:
99201-3602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-626-9825
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2006