Provider First Line Business Practice Location Address:
4610 N ASH ST STE 101
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:
99205-1482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-326-2660
Provider Business Practice Location Address Fax Number:
509-326-2510
Provider Enumeration Date:
12/20/2006