Provider First Line Business Practice Location Address:
12 E 5TH 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:
99202-1309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-4978
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/23/2007