Provider First Line Business Practice Location Address:
915 EAST HAWTHORNE ROAD
Provider Second Line Business Practice Location Address:
SUITE G
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-464-4100
Provider Business Practice Location Address Fax Number:
509-464-4104
Provider Enumeration Date:
05/03/2007