Provider First Line Business Practice Location Address:
507 S WASHINGTON ST STE 140
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:
99204-2629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-2706
Provider Business Practice Location Address Fax Number:
509-838-2973
Provider Enumeration Date:
05/12/2006