Provider First Line Business Practice Location Address:
1100 W 6TH AVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-3104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-1508
Provider Business Practice Location Address Fax Number:
509-456-3403
Provider Enumeration Date:
12/12/2006