Provider First Line Business Practice Location Address:
3321 W INDIAN TRAIL RD
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:
99208-4762
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-325-8720
Provider Business Practice Location Address Fax Number:
509-325-7625
Provider Enumeration Date:
08/22/2013