Provider First Line Business Practice Location Address:
62 W 7TH AVE STE 110
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:
99204-2321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-456-0262
Provider Business Practice Location Address Fax Number:
509-462-5059
Provider Enumeration Date:
02/13/2006