Provider First Line Business Practice Location Address:
315 W 9TH AVE STE 200
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:
509-960-8894
Provider Business Practice Location Address Fax Number:
509-290-6820
Provider Enumeration Date:
10/09/2006