Provider First Line Business Practice Location Address:
35 W 8TH 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:
99204-2361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-456-6556
Provider Business Practice Location Address Fax Number:
509-455-8801
Provider Enumeration Date:
04/17/2006