Provider First Line Business Practice Location Address:
9 S WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE 709
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-3719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-1456
Provider Business Practice Location Address Fax Number:
509-448-4420
Provider Enumeration Date:
08/27/2007