Provider First Line Business Practice Location Address:
122 WEST 7TH AVENUE
Provider Second Line Business Practice Location Address:
SUITE 450
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-4332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-2960
Provider Business Practice Location Address Fax Number:
509-459-0424
Provider Enumeration Date:
05/10/2006