Provider First Line Business Practice Location Address:
2520 E 9TH 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:
99202-4224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-979-9255
Provider Business Practice Location Address Fax Number:
509-926-1518
Provider Enumeration Date:
07/18/2007