Provider First Line Business Practice Location Address:
701 W 7TH AVE
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-998-2842
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2007