Provider First Line Business Practice Location Address:
820 S MCCLELLAN ST STE 118
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:
99204-2446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-464-7880
Provider Business Practice Location Address Fax Number:
509-464-7961
Provider Enumeration Date:
03/25/2009