Provider First Line Business Practice Location Address:
323 E SECOND AVENUE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-5555
Provider Business Practice Location Address Fax Number:
509-455-4114
Provider Enumeration Date:
05/28/2006