Provider First Line Business Practice Location Address:
1212 N WASHINGTON ST STE 204
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:
99201-2401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-389-1772
Provider Business Practice Location Address Fax Number:
509-267-2717
Provider Enumeration Date:
02/19/2016