Provider First Line Business Practice Location Address:
20 W MAIN AVE
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:
99201-0172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-9200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2007