Provider First Line Business Practice Location Address:
2204 E 29H AVE
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99203-3961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-535-9515
Provider Business Practice Location Address Fax Number:
509-535-9525
Provider Enumeration Date:
05/12/2011