Provider First Line Business Practice Location Address:
9222 N NEWPORT HWY
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-4545
Provider Business Practice Location Address Fax Number:
509-467-2304
Provider Enumeration Date:
08/29/2006