Provider First Line Business Practice Location Address:
910 W 5TH AVE STE 501570
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:
99204-2966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-755-5220
Provider Business Practice Location Address Fax Number:
509-455-8828
Provider Enumeration Date:
10/02/2006