Provider First Line Business Practice Location Address:
3017 E FRANCIS
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-2435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-0057
Provider Business Practice Location Address Fax Number:
509-467-4834
Provider Enumeration Date:
01/14/2009