Provider First Line Business Practice Location Address:
515 W FRANCIS 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:
99205-6413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-5762
Provider Business Practice Location Address Fax Number:
509-327-2198
Provider Enumeration Date:
10/24/2007