Provider First Line Business Practice Location Address:
10103 N DIVISION ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-1380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-9111
Provider Business Practice Location Address Fax Number:
509-468-1294
Provider Enumeration Date:
01/05/2010