Provider First Line Business Practice Location Address:
12 E. EMPIRE 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:
99207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-325-0781
Provider Business Practice Location Address Fax Number:
509-325-0380
Provider Enumeration Date:
10/20/2011