Provider First Line Business Practice Location Address:
4007 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:
99207-5825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-443-3424
Provider Business Practice Location Address Fax Number:
509-315-8502
Provider Enumeration Date:
11/11/2015