Provider First Line Business Practice Location Address:
2702 W SUNSET BLVD
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:
99224-1112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-835-4000
Provider Business Practice Location Address Fax Number:
509-835-4252
Provider Enumeration Date:
05/30/2007