Provider First Line Business Practice Location Address:
103 W INDIANA AVE
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:
99205-4828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-328-8200
Provider Business Practice Location Address Fax Number:
509-328-8202
Provider Enumeration Date:
12/07/2005