Provider First Line Business Practice Location Address:
611 N PERRY ST
Provider Second Line Business Practice Location Address:
BLDG #2, SUITE 202
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-5011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-434-1727
Provider Business Practice Location Address Fax Number:
509-536-6464
Provider Enumeration Date:
04/08/2010