Provider First Line Business Practice Location Address:
1730 E WABASH 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:
99207-4251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-936-4534
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/13/2015