Provider First Line Business Practice Location Address:
618 E LIBERTY 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:
99207-2856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-481-5757
Provider Business Practice Location Address Fax Number:
509-326-6165
Provider Enumeration Date:
11/12/2015