Provider First Line Business Practice Location Address:
724 1/2 E BALDWIN 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:
99207-2503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-382-9942
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2015