Provider First Line Business Practice Location Address:
TAPIO CENTER, 104 S FREYA ST
Provider Second Line Business Practice Location Address:
WHITE FLAG BUILDING, STE 221
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-204-5182
Provider Business Practice Location Address Fax Number:
509-497-5004
Provider Enumeration Date:
02/18/2011