Provider First Line Business Practice Location Address:
1817 E SPRINGFIELD AVE STE D
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:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-771-0510
Provider Business Practice Location Address Fax Number:
509-381-3518
Provider Enumeration Date:
09/17/2012