Provider First Line Business Practice Location Address:
3009 S. MT VERNON
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:
99223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-534-2666
Provider Business Practice Location Address Fax Number:
509-534-1392
Provider Enumeration Date:
07/19/2007