Provider First Line Business Practice Location Address:
1616 W NORTHWEST BLVD
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:
99205-4275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-327-5010
Provider Business Practice Location Address Fax Number:
509-327-5368
Provider Enumeration Date:
06/21/2006