Provider First Line Business Practice Location Address:
2525 E 29TH AVE
Provider Second Line Business Practice Location Address:
STE 10-B #284
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99223-4855
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-869-3239
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2007