Provider First Line Business Practice Location Address:
422 W RIVERSIDE AVE STE 501
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:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-474-1976
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2010