Provider First Line Business Practice Location Address:
322 W NORTH RIVER DR
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:
99201-3208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-241-2050
Provider Business Practice Location Address Fax Number:
509-324-3702
Provider Enumeration Date:
04/09/2007