Provider First Line Business Practice Location Address:
400 E 5TH AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-1334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-3588
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2006