Provider First Line Business Practice Location Address:
507 S WASHINGTON 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:
99204-2608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-249-3739
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/22/2016