Provider First Line Business Practice Location Address:
327 W 3RD AVE STE A
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:
99201-5082
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-0175
Provider Business Practice Location Address Fax Number:
509-838-2660
Provider Enumeration Date:
06/09/2009