Provider First Line Business Practice Location Address:
785 E HOLLAND 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:
99218-1257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-466-6393
Provider Business Practice Location Address Fax Number:
509-466-3072
Provider Enumeration Date:
02/03/2011