Provider First Line Business Practice Location Address:
3919 N MARKET ST
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:
99207-5813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-482-3480
Provider Business Practice Location Address Fax Number:
509-482-0535
Provider Enumeration Date:
11/08/2010