Provider First Line Business Practice Location Address:
525 W 2ND 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:
99201-4301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-2378
Provider Business Practice Location Address Fax Number:
509-624-2275
Provider Enumeration Date:
09/19/2007