Provider First Line Business Practice Location Address:
1330 N WASHINGTON ST STE 4200
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:
99201-2476
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-1624
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2006