Provider First Line Business Practice Location Address:
8101 S OAK RD
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:
99224-9667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-534-4033
Provider Business Practice Location Address Fax Number:
509-448-7280
Provider Enumeration Date:
01/26/2011