Provider First Line Business Practice Location Address:
2718 E 57TH AVE STE 103
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:
99223-6605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-448-9990
Provider Business Practice Location Address Fax Number:
509-448-9991
Provider Enumeration Date:
06/02/2009