Provider First Line Business Practice Location Address:
400 S JEFFERSON ST STE 204
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:
99204-3142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-342-6592
Provider Business Practice Location Address Fax Number:
509-318-2020
Provider Enumeration Date:
01/22/2014