Provider First Line Business Practice Location Address:
421 W RIVERSIDE AVE STE 310
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:
99201-2458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-1440
Provider Business Practice Location Address Fax Number:
509-747-4420
Provider Enumeration Date:
07/30/2006