Provider First Line Business Practice Location Address:
2118 W GARLAND 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:
99205-2526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-1651
Provider Business Practice Location Address Fax Number:
509-326-1658
Provider Enumeration Date:
11/15/2006