Provider First Line Business Practice Location Address:
1725 W COURTLAND AVE STE I
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:
99205-2612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-842-6869
Provider Business Practice Location Address Fax Number:
509-290-5336
Provider Enumeration Date:
10/04/2012