Provider First Line Business Practice Location Address:
1616 W WELLESLEY SUITE C
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-6654
Provider Business Practice Location Address Fax Number:
509-327-3436
Provider Enumeration Date:
02/27/2007