Provider First Line Business Practice Location Address:
3919 N MAPLE ST
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:
99205-1349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-444-8200
Provider Business Practice Location Address Fax Number:
509-462-6571
Provider Enumeration Date:
07/24/2014