Provider First Line Business Practice Location Address:
1801 W BROADWAY AVE STE 1
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:
99201-1819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-1770
Provider Business Practice Location Address Fax Number:
509-838-2020
Provider Enumeration Date:
01/11/2010