Provider First Line Business Practice Location Address:
5921 N MARKET ST
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:
99208-2484
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-343-1116
Provider Business Practice Location Address Fax Number:
509-434-1923
Provider Enumeration Date:
12/17/2010