Provider First Line Business Practice Location Address:
6029 N. DIVISION STREET
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:
99207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-482-4900
Provider Business Practice Location Address Fax Number:
509-482-0814
Provider Enumeration Date:
01/23/2007