Provider First Line Business Practice Location Address:
307 W 6TH AVE STE 200
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:
99204-2502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-324-2980
Provider Business Practice Location Address Fax Number:
94-189-4625
Provider Enumeration Date:
06/27/2011