Provider First Line Business Practice Location Address:
508 W 7TH 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:
99204-2731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-5208
Provider Business Practice Location Address Fax Number:
509-624-5209
Provider Enumeration Date:
12/12/2006