Provider First Line Business Practice Location Address:
815 W 7TH 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:
99204-2839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-534-9407
Provider Business Practice Location Address Fax Number:
509-536-2804
Provider Enumeration Date:
01/16/2007