Provider First Line Business Practice Location Address:
933 W. 3RD AVE SUITE 214
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:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-230-2112
Provider Business Practice Location Address Fax Number:
509-747-5443
Provider Enumeration Date:
01/03/2007