Provider First Line Business Practice Location Address:
104 W 5TH AVE STE 390E
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:
99204-4817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-777-8778
Provider Business Practice Location Address Fax Number:
509-777-8790
Provider Enumeration Date:
05/25/2007