Provider First Line Business Practice Location Address:
303 E WELLESLEY AVE
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:
99207-1578
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-535-1546
Provider Business Practice Location Address Fax Number:
509-535-4635
Provider Enumeration Date:
03/31/2010