Provider First Line Business Practice Location Address:
1208 W MALLON AVE
Provider Second Line Business Practice Location Address:
SPOKANE COUNTY JUVENILE COURT
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-477-2406
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2012