Provider First Line Business Practice Location Address:
802 E 29TH AVE 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:
99203-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-475-8989
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/02/2007