Provider First Line Business Practice Location Address:
104 W 5TH AVE STE 290E
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:
99204-4812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-5586
Provider Business Practice Location Address Fax Number:
509-624-9288
Provider Enumeration Date:
08/16/2016