Provider First Line Business Practice Location Address:
126 W COLUMBIA 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:
99205-6225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-482-2790
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2011