Provider First Line Business Practice Location Address:
621 W MALLON AVE
Provider Second Line Business Practice Location Address:
SUITES 501-503
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-5546
Provider Business Practice Location Address Fax Number:
509-455-5201
Provider Enumeration Date:
05/01/2007