Provider First Line Business Practice Location Address:
2204 E 29TH AVE STE 206
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:
99203-3961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-795-2025
Provider Business Practice Location Address Fax Number:
509-984-4324
Provider Enumeration Date:
11/08/2013