Provider First Line Business Practice Location Address:
4610 N ASH ST STE 204
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:
509-326-8120
Provider Business Practice Location Address Fax Number:
509-325-5370
Provider Enumeration Date:
06/06/2012