Provider First Line Business Practice Location Address:
1016 N SUPERIOR
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:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-358-0060
Provider Business Practice Location Address Fax Number:
509-326-0224
Provider Enumeration Date:
10/03/2006