Provider First Line Business Practice Location Address:
3828 E 29TH 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:
99223-5765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-534-6509
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2008