Provider First Line Business Practice Location Address:
9671 N NEVADA ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-1146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-3336
Provider Business Practice Location Address Fax Number:
509-467-3970
Provider Enumeration Date:
06/08/2012