Provider First Line Business Practice Location Address:
400 S JEFFERSON ST STE 109E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-3121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-934-2210
Provider Business Practice Location Address Fax Number:
509-215-3224
Provider Enumeration Date:
04/01/2010