Provider First Line Business Practice Location Address:
122 W 7TH AVE
Provider Second Line Business Practice Location Address:
STE 310
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-847-2500
Provider Business Practice Location Address Fax Number:
509-847-2501
Provider Enumeration Date:
06/25/2008