Provider First Line Business Practice Location Address:
430 WEST 2ND AVE
Provider Second Line Business Practice Location Address:
#101
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-0282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-481-5841
Provider Business Practice Location Address Fax Number:
509-727-0620
Provider Enumeration Date:
01/26/2007