Provider First Line Business Practice Location Address:
203 E DALKE AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-8112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-4249
Provider Business Practice Location Address Fax Number:
509-483-8338
Provider Enumeration Date:
04/20/2012