Provider First Line Business Practice Location Address:
5011 W LOWELL AVE STE 100
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:
99208-8587
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-385-0610
Provider Business Practice Location Address Fax Number:
509-227-7070
Provider Enumeration Date:
01/02/2006