Provider First Line Business Practice Location Address:
1220 N HOWARD 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:
99201-2410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-7913
Provider Business Practice Location Address Fax Number:
509-467-0344
Provider Enumeration Date:
02/17/2011