Provider First Line Business Practice Location Address:
714 W 20TH 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:
99203-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-321-8921
Provider Business Practice Location Address Fax Number:
206-480-0848
Provider Enumeration Date:
02/07/2007