Provider First Line Business Practice Location Address:
820 N SUMMIT BLVD
Provider Second Line Business Practice Location Address:
STE. 100
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-1571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-325-7667
Provider Business Practice Location Address Fax Number:
509-325-7675
Provider Enumeration Date:
05/29/2007