Provider First Line Business Practice Location Address:
1101 W COLLEGE 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:
99201-2010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-324-1420
Provider Business Practice Location Address Fax Number:
509-324-3622
Provider Enumeration Date:
11/04/2005