Provider First Line Business Practice Location Address:
910 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-939-0622
Provider Business Practice Location Address Fax Number:
509-325-4988
Provider Enumeration Date:
02/12/2007