Provider First Line Business Practice Location Address:
105 W 8TH AVE
Provider Second Line Business Practice Location Address:
STE 250
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-464-6208
Provider Business Practice Location Address Fax Number:
888-316-1928
Provider Enumeration Date:
12/04/2006