Provider First Line Business Practice Location Address:
123 E INDIANA AVE STE 100
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:
99207-2313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-241-4220
Provider Business Practice Location Address Fax Number:
509-241-4269
Provider Enumeration Date:
03/03/2006