Provider First Line Business Practice Location Address:
101 W 8TH AVE FL 3
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:
99204-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-474-2777
Provider Business Practice Location Address Fax Number:
509-474-6222
Provider Enumeration Date:
01/30/2007