Provider First Line Business Practice Location Address:
1124 E 35TH 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:
99203-3168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-7460
Provider Business Practice Location Address Fax Number:
509-323-5965
Provider Enumeration Date:
02/02/2007