Provider First Line Business Practice Location Address:
111 E LINCOLN RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-6901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-939-8404
Provider Business Practice Location Address Fax Number:
509-487-5717
Provider Enumeration Date:
01/09/2007