Provider First Line Business Practice Location Address:
7826 N MARKET ST STE B
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:
99217-7857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-487-9037
Provider Business Practice Location Address Fax Number:
509-487-2251
Provider Enumeration Date:
04/23/2007