Provider First Line Business Practice Location Address:
801 W 5TH AVE
Provider Second Line Business Practice Location Address:
SUITE 619
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-4588
Provider Business Practice Location Address Fax Number:
509-624-4683
Provider Enumeration Date:
02/20/2007