Provider First Line Business Practice Location Address:
16320 E LINCOLN RD
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:
99217-9571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-1412
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/18/2012