Provider First Line Business Practice Location Address:
621 W MALLON AVE
Provider Second Line Business Practice Location Address:
300
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-325-6100
Provider Business Practice Location Address Fax Number:
509-326-1912
Provider Enumeration Date:
05/28/2007