Provider First Line Business Practice Location Address:
1113 E 38TH 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:
99203-3022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-496-3526
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2012