Provider First Line Business Practice Location Address:
1403 W GARLAND AVE STE B
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:
99205-2619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-325-2992
Provider Business Practice Location Address Fax Number:
509-326-5112
Provider Enumeration Date:
10/06/2006