Provider First Line Business Practice Location Address:
911 W 5TH 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:
99204-2910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-623-0428
Provider Business Practice Location Address Fax Number:
509-623-0415
Provider Enumeration Date:
06/17/2013