Provider First Line Business Practice Location Address:
1312 N MONROE ST
Provider Second Line Business Practice Location Address:
SUITE 241
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-954-0184
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2007