Provider First Line Business Practice Location Address:
225 E 3RD AVE
Provider Second Line Business Practice Location Address:
SUITE # 5
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-1422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-2929
Provider Business Practice Location Address Fax Number:
509-838-2920
Provider Enumeration Date:
07/28/2005