Provider First Line Business Practice Location Address:
1401 E TRENT AVE STE 200
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:
99202-2902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-3147
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2006