Provider First Line Business Practice Location Address:
4407 N DIVISION ST
Provider Second Line Business Practice Location Address:
SUITE 501
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-3670
Provider Business Practice Location Address Fax Number:
509-489-3687
Provider Enumeration Date:
11/15/2006