Provider First Line Business Practice Location Address:
22 W CENTRAL 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:
99205-6221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-482-2080
Provider Business Practice Location Address Fax Number:
509-482-2042
Provider Enumeration Date:
05/14/2007