Provider First Line Business Practice Location Address:
508 W 6TH AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-993-4184
Provider Business Practice Location Address Fax Number:
509-747-5222
Provider Enumeration Date:
09/21/2011