Provider First Line Business Practice Location Address:
2726 W SINTO 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:
99201-3027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-328-7041
Provider Business Practice Location Address Fax Number:
508-328-7582
Provider Enumeration Date:
04/30/2015