Provider First Line Business Practice Location Address:
N 1212 WASHINGTON
Provider Second Line Business Practice Location Address:
GRASSROOTS THERAPY GROUP SUITE 204
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-279-8838
Provider Business Practice Location Address Fax Number:
509-464-6239
Provider Enumeration Date:
03/10/2012