Provider First Line Business Practice Location Address:
709 W 22ND 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:
99203-1961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-435-3372
Provider Business Practice Location Address Fax Number:
509-368-9944
Provider Enumeration Date:
07/24/2012