Provider First Line Business Practice Location Address:
707 W 7TH AVE
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-8418
Provider Business Practice Location Address Fax Number:
509-624-5056
Provider Enumeration Date:
03/08/2007