Provider First Line Business Practice Location Address:
GONZAGA UNIVERSITY MSC 3838
Provider Second Line Business Practice Location Address:
502 E BOONE AVE.
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99258-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-438-2726
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2016