Provider First Line Business Practice Location Address:
212 E CENTRAL AVE STE 215
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:
99208-6477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-6401
Provider Business Practice Location Address Fax Number:
509-325-5986
Provider Enumeration Date:
12/06/2017