Provider First Line Business Practice Location Address:
124 E AUGUSTA AVE.
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207-2479
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-325-4874
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2007