Provider First Line Business Practice Location Address:
905 W. FRANCES
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:
99205-6513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-6114
Provider Business Practice Location Address Fax Number:
509-432-7487
Provider Enumeration Date:
11/15/2006