Provider First Line Business Practice Location Address:
705 W. 7TH AVENUE
Provider Second Line Business Practice Location Address:
SUITE 1-C
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-499-1028
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2007