Provider First Line Business Practice Location Address:
14415 SPRAGUE AVE
Provider Second Line Business Practice Location Address:
#7
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-922-4075
Provider Business Practice Location Address Fax Number:
509-922-4189
Provider Enumeration Date:
05/25/2006