Provider First Line Business Practice Location Address:
7701 N DIVISION ST
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:
99208-5615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-465-3161
Provider Business Practice Location Address Fax Number:
509-465-1812
Provider Enumeration Date:
05/25/2006