Provider First Line Business Practice Location Address:
8714 N DIVISION ST
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:
99218-1106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-5230
Provider Business Practice Location Address Fax Number:
509-467-1103
Provider Enumeration Date:
06/28/2011