Provider First Line Business Practice Location Address:
N 4700 DIVISION
Provider Second Line Business Practice Location Address:
NORTHTOWN MALL
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207-1402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-482-5593
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/28/2006