Provider First Line Business Practice Location Address:
111 W CATALDO AVE
Provider Second Line Business Practice Location Address:
#200
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-624-5826
Provider Business Practice Location Address Fax Number:
509-624-1418
Provider Enumeration Date:
09/27/2006