Provider First Line Business Practice Location Address:
3010 S. SOUTHEAST BLVD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-688-6710
Provider Business Practice Location Address Fax Number:
503-533-1838
Provider Enumeration Date:
11/20/2012