Provider First Line Business Practice Location Address:
3515 S LLOYD 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:
99223-1163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-319-9599
Provider Business Practice Location Address Fax Number:
509-315-8807
Provider Enumeration Date:
04/18/2007