Provider First Line Business Practice Location Address:
2659 N ASH ST
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:
99205-3606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-0701
Provider Business Practice Location Address Fax Number:
509-324-3669
Provider Enumeration Date:
06/05/2008