Provider First Line Business Practice Location Address:
1212 N WASHINGTON ST STE 327
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:
99201-2403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-505-4567
Provider Business Practice Location Address Fax Number:
509-505-4115
Provider Enumeration Date:
08/05/2016