Provider First Line Business Practice Location Address:
2607 S SOUTHEAST BLVD STE B211
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:
99223-7614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-443-4357
Provider Business Practice Location Address Fax Number:
509-242-3592
Provider Enumeration Date:
04/16/2007