Provider First Line Business Practice Location Address:
2020 E 29TH AVE STE 235
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:
99203-3949
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-673-7221
Provider Business Practice Location Address Fax Number:
509-572-9243
Provider Enumeration Date:
08/17/2005