Provider First Line Business Practice Location Address:
601 W 1ST AVE
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:
99201-3825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-482-2551
Provider Business Practice Location Address Fax Number:
509-482-1857
Provider Enumeration Date:
10/11/2006