Provider First Line Business Practice Location Address:
539 W SHARP AVE STE 150
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:
99201-2460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-879-6244
Provider Business Practice Location Address Fax Number:
509-328-9919
Provider Enumeration Date:
06/18/2007