Provider First Line Business Practice Location Address:
9425 N NEVADA ST STE 100
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:
99218-1286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-232-7223
Provider Business Practice Location Address Fax Number:
509-328-5949
Provider Enumeration Date:
10/04/2006