Provider First Line Business Practice Location Address:
421 WEST RIVERSIDE AVENUE
Provider Second Line Business Practice Location Address:
SUITE 602
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-7878
Provider Business Practice Location Address Fax Number:
509-455-7005
Provider Enumeration Date:
02/21/2007