Provider First Line Business Practice Location Address:
421 S DIVISION ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-1331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-474-5858
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2008