Provider First Line Business Practice Location Address:
701 EAST 3RD AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-2204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-532-8855
Provider Business Practice Location Address Fax Number:
509-532-8844
Provider Enumeration Date:
09/23/2006