Provider First Line Business Practice Location Address:
1315 N DIVISION 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:
99202-1899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-0908
Provider Business Practice Location Address Fax Number:
509-459-0881
Provider Enumeration Date:
01/18/2006