Provider First Line Business Practice Location Address:
N 1212 WASHINGTON
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-279-8838
Provider Business Practice Location Address Fax Number:
509-267-2717
Provider Enumeration Date:
07/22/2013