Provider First Line Business Practice Location Address:
910 W 5TH AVE STE 1001
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:
99204-2976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
950-983-8253
Provider Business Practice Location Address Fax Number:
509-755-6580
Provider Enumeration Date:
04/12/2010