Provider First Line Business Practice Location Address:
1808 W 3RD 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:
99201-7410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-0126
Provider Business Practice Location Address Fax Number:
509-456-2358
Provider Enumeration Date:
10/21/2011