Provider First Line Business Practice Location Address:
707 W 7TH AVE SUITE #223
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:
509-455-9104
Provider Business Practice Location Address Fax Number:
509-455-7171
Provider Enumeration Date:
05/21/2008