Provider First Line Business Practice Location Address:
2816 E 30TH 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:
99223-4782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-535-5771
Provider Business Practice Location Address Fax Number:
509-535-5782
Provider Enumeration Date:
01/01/2015