Provider First Line Business Practice Location Address:
10925 N NEWPORT HWY STE 10
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:
99218-1646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-468-2055
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2009