Provider First Line Business Practice Location Address:
2429 E NORTH ALTAMONT BLVD
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:
99202-4245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-443-0190
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/28/2006