Provider First Line Business Practice Location Address:
730 N HAMILTON 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:
99202-2045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-458-7686
Provider Business Practice Location Address Fax Number:
509-458-6611
Provider Enumeration Date:
01/26/2011