Provider First Line Business Practice Location Address:
123 W FRANCIS AVE STE 103
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:
99205-6348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-8863
Provider Business Practice Location Address Fax Number:
509-489-8744
Provider Enumeration Date:
06/16/2008