Provider First Line Business Practice Location Address:
513 E HASTINGS RD STE C
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:
99218-1977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-328-2632
Provider Business Practice Location Address Fax Number:
509-324-2377
Provider Enumeration Date:
01/17/2007