Provider First Line Business Practice Location Address:
626 S. SHERIDAN ST
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:
99202-1325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-279-2176
Provider Business Practice Location Address Fax Number:
509-279-2941
Provider Enumeration Date:
07/07/2011