Provider First Line Business Practice Location Address:
319 W HASTINGS RD
Provider Second Line Business Practice Location Address:
SUITE A-106
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-5012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-385-4959
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/16/2006