Provider First Line Business Practice Location Address:
140 S ARTHUR ST
Provider Second Line Business Practice Location Address:
STE 670
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-2220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-462-4567
Provider Business Practice Location Address Fax Number:
509-462-1162
Provider Enumeration Date:
06/20/2005