Provider First Line Business Practice Location Address:
104 S FREYA ST
Provider Second Line Business Practice Location Address:
LILAC FLAG, SUITE 218
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-279-5738
Provider Business Practice Location Address Fax Number:
509-863-9469
Provider Enumeration Date:
09/10/2008