Provider First Line Business Practice Location Address:
212 E CENTRAL AVE
Provider Second Line Business Practice Location Address:
STE 140
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-6289
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-465-1300
Provider Business Practice Location Address Fax Number:
509-465-1313
Provider Enumeration Date:
02/27/2006