Provider First Line Business Practice Location Address:
202 E SPOKANE FALLS BLVD
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:
99202-1612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-251-3590
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2010