Provider First Line Business Practice Location Address:
703 W 7TH AVE
Provider Second Line Business Practice Location Address:
MARYCLIFF CENTER, SUITE 300
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-953-6857
Provider Business Practice Location Address Fax Number:
509-443-6362
Provider Enumeration Date:
02/06/2008