Provider First Line Business Practice Location Address:
100 W HOWARD ST.
Provider Second Line Business Practice Location Address:
SUITE W
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-319-6113
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/05/2010