Provider First Line Business Practice Location Address:
508 W 6TH AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-7535
Provider Business Practice Location Address Fax Number:
509-535-1637
Provider Enumeration Date:
02/02/2007