Provider First Line Business Practice Location Address:
6701 N COUNTRY HOMES BLVD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-4336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-328-1792
Provider Business Practice Location Address Fax Number:
509-328-1265
Provider Enumeration Date:
01/03/2007