Provider First Line Business Practice Location Address:
3131 N DIVISION 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:
99207-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-324-8612
Provider Business Practice Location Address Fax Number:
509-324-0357
Provider Enumeration Date:
02/19/2007