Provider First Line Business Practice Location Address:
6 W JOSEPH
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-483-1221
Provider Business Practice Location Address Fax Number:
509-483-0647
Provider Enumeration Date:
06/05/2007