Provider First Line Business Practice Location Address:
820 S MCCLELLAN ST STE 200
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:
99204-2456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-1144
Provider Business Practice Location Address Fax Number:
509-227-7070
Provider Enumeration Date:
10/23/2006