Provider First Line Business Practice Location Address:
212 E CENTRAL AVE
Provider Second Line Business Practice Location Address:
STE 4440
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-6291
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-252-9602
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2006