Provider First Line Business Practice Location Address:
1817 E SPRINGFIELD AVE
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-2913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-202-6596
Provider Business Practice Location Address Fax Number:
509-290-6566
Provider Enumeration Date:
06/25/2014