Provider First Line Business Practice Location Address:
801 W 5TH AVENUE
Provider Second Line Business Practice Location Address:
SUITE 205
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:
509-747-1187
Provider Business Practice Location Address Fax Number:
509-747-1180
Provider Enumeration Date:
05/04/2006