Provider First Line Business Practice Location Address:
1203 W FRANCIS 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:
99205-6640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-328-7575
Provider Business Practice Location Address Fax Number:
509-328-5031
Provider Enumeration Date:
10/13/2009