Provider First Line Business Practice Location Address:
521 W. GARLAND AVENUE
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:
99205-2954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-9505
Provider Business Practice Location Address Fax Number:
509-325-3277
Provider Enumeration Date:
10/03/2006