Provider First Line Business Practice Location Address:
122 W. 7TH AVENUE
Provider Second Line Business Practice Location Address:
STE. 450
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-8820
Provider Business Practice Location Address Fax Number:
509-838-4978
Provider Enumeration Date:
05/18/2007