Provider First Line Business Practice Location Address:
1801 W. BROADWAY AVE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-755-5100
Provider Business Practice Location Address Fax Number:
509-747-6646
Provider Enumeration Date:
02/15/2007