Provider First Line Business Practice Location Address:
2110 N WASHINGTON ST STE 1
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:
99205-4702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-4373
Provider Business Practice Location Address Fax Number:
509-327-1244
Provider Enumeration Date:
07/20/2006