Provider First Line Business Practice Location Address:
4 815 N ASSEMBLY ST
Provider Second Line Business Practice Location Address:
V A MED CENTER
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99205-6197
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-434-7932
Provider Business Practice Location Address Fax Number:
509-434-7142
Provider Enumeration Date:
06/17/2009