Provider First Line Business Practice Location Address:
624 W HASTINGS RD
Provider Second Line Business Practice Location Address:
SUITE 9
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-9072
Provider Business Practice Location Address Fax Number:
509-624-5016
Provider Enumeration Date:
10/05/2006