Provider First Line Business Practice Location Address:
605 E HOLLAND AVE
Provider Second Line Business Practice Location Address:
STE 114
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-2225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-340-1000
Provider Business Practice Location Address Fax Number:
509-467-2289
Provider Enumeration Date:
02/26/2007