Provider First Line Business Practice Location Address:
9770 N NEWPORT HWY
Provider Second Line Business Practice Location Address:
TARGET PHARMACY T0636
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-1249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-466-7226
Provider Business Practice Location Address Fax Number:
509-795-3177
Provider Enumeration Date:
07/11/2012