Provider First Line Business Practice Location Address:
3600 E HARTSON 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:
99202-5102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-535-2071
Provider Business Practice Location Address Fax Number:
509-536-7741
Provider Enumeration Date:
05/19/2006