Provider First Line Business Practice Location Address:
9671 N NEVADA ST STE 210
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:
99218-1146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-468-2020
Provider Business Practice Location Address Fax Number:
509-468-3272
Provider Enumeration Date:
01/18/2008