Provider First Line Business Practice Location Address:
1206 N LINCOLN ST
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-835-4404
Provider Business Practice Location Address Fax Number:
509-835-4400
Provider Enumeration Date:
10/01/2012