Provider First Line Business Practice Location Address:
16201 E. INDIANA AVE
Provider Second Line Business Practice Location Address:
STE 2300
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99216-2839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-924-8721
Provider Business Practice Location Address Fax Number:
509-927-9593
Provider Enumeration Date:
10/05/2009