Provider First Line Business Practice Location Address:
62 W 7TH AVE STE 110
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:
99204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-462-6485
Provider Business Practice Location Address Fax Number:
509-346-2650
Provider Enumeration Date:
10/23/2014