Provider First Line Business Practice Location Address:
507 S SHERMAN ST
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:
99202-4918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-363-0100
Provider Business Practice Location Address Fax Number:
509-363-6500
Provider Enumeration Date:
07/18/2005