Provider First Line Business Practice Location Address:
3211 N WELLINGTON PL
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:
99205-2166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-3694
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2007