Provider First Line Business Practice Location Address:
1212 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
206
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:
509-209-9486
Provider Business Practice Location Address Fax Number:
509-232-0883
Provider Enumeration Date:
04/10/2012