Provider First Line Business Practice Location Address:
105 W 8TH AVE STE 512C
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:
99204-2318
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:
509-468-0702
Provider Enumeration Date:
06/12/2006