Provider First Line Business Practice Location Address:
5952 BLACKSTONE WAY
Provider Second Line Business Practice Location Address:
LAKE SPOKANE COMMUNITY HEALTH CENTER
Provider Business Practice Location Address City Name:
NINE MILE FALLS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99026-4900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-464-3627
Provider Business Practice Location Address Fax Number:
509-466-9517
Provider Enumeration Date:
01/25/2006