Provider First Line Business Practice Location Address:
3022 E 57TH AVE
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99223-7033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-443-8910
Provider Business Practice Location Address Fax Number:
509-443-8911
Provider Enumeration Date:
11/22/2005