Provider First Line Business Practice Location Address:
601 W 5TH AVE STE 308
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:
509-624-2353
Provider Business Practice Location Address Fax Number:
360-338-0257
Provider Enumeration Date:
05/24/2007