Provider First Line Business Practice Location Address:
251 E 5TH AVE STE B
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:
99202-1327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-744-3244
Provider Business Practice Location Address Fax Number:
509-744-8554
Provider Enumeration Date:
08/30/2016