Provider First Line Business Practice Location Address:
212 E CENTRAL AVE STE 315
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:
99208-6290
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-465-3919
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2007