Provider First Line Business Practice Location Address:
820 S MCCLELLAN ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-1144
Provider Business Practice Location Address Fax Number:
509-455-4166
Provider Enumeration Date:
07/23/2008