Provider First Line Business Practice Location Address:
1602 E SPRAGUE 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:
99202-3115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-747-7888
Provider Business Practice Location Address Fax Number:
855-317-6308
Provider Enumeration Date:
08/31/2006