Provider First Line Business Practice Location Address:
401 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:
99203-2507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-3559
Provider Business Practice Location Address Fax Number:
509-838-1554
Provider Enumeration Date:
01/31/2008