Provider First Line Business Practice Location Address:
525 E FRANCIS 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:
99208-1039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-2085
Provider Business Practice Location Address Fax Number:
509-489-0248
Provider Enumeration Date:
06/23/2006