Provider First Line Business Practice Location Address:
2103 W PACIFIC 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-744-3244
Provider Business Practice Location Address Fax Number:
509-744-8554
Provider Enumeration Date:
11/07/2006