Provider First Line Business Practice Location Address:
412 E SPOKANE FALLS BLVD
Provider Second Line Business Practice Location Address:
HSB 210L
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-2131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-661-8628
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/17/2014