Provider First Line Business Practice Location Address:
3426 S UNIVERSITY 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:
99206-1268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-921-2292
Provider Business Practice Location Address Fax Number:
509-343-1117
Provider Enumeration Date:
02/16/2015