Provider First Line Business Practice Location Address:
2527 E 27TH AVE
Provider Second Line Business Practice Location Address:
SUITE C205
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99223-4909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-535-0656
Provider Business Practice Location Address Fax Number:
509-535-0638
Provider Enumeration Date:
04/16/2008