Provider First Line Business Practice Location Address:
910 W 5TH 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:
99204-2966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-273-2352
Provider Business Practice Location Address Fax Number:
509-473-7663
Provider Enumeration Date:
10/16/2006