Provider First Line Business Practice Location Address:
105 W 8TH AVE
Provider Second Line Business Practice Location Address:
SUITE 332C
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-7400
Provider Business Practice Location Address Fax Number:
509-838-6827
Provider Enumeration Date:
08/31/2006