Provider First Line Business Practice Location Address:
17 E 8TH 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:
99202-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-966-8375
Provider Business Practice Location Address Fax Number:
360-253-5170
Provider Enumeration Date:
11/01/2006