Provider First Line Business Practice Location Address:
701 W 7TH AVE
Provider Second Line Business Practice Location Address:
SUITE130
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-220-9601
Provider Business Practice Location Address Fax Number:
509-747-6817
Provider Enumeration Date:
08/29/2006