Provider First Line Business Practice Location Address:
707 W FRANCIS AVE
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99205-6401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-3368
Provider Business Practice Location Address Fax Number:
509-325-2712
Provider Enumeration Date:
06/16/2005