Provider First Line Business Practice Location Address:
933 W 3RD AVE
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-4512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-1770
Provider Business Practice Location Address Fax Number:
509-838-3331
Provider Enumeration Date:
04/02/2007