Provider First Line Business Practice Location Address:
2829 S GRAND BLVD
Provider Second Line Business Practice Location Address:
STE 301
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-4242
Provider Business Practice Location Address Fax Number:
509-747-3512
Provider Enumeration Date:
11/22/2006