Provider First Line Business Practice Location Address:
105 W 8TH
Provider Second Line Business Practice Location Address:
SUITE 7060
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-6194
Provider Business Practice Location Address Fax Number:
509-747-4313
Provider Enumeration Date:
02/02/2006