Provider First Line Business Practice Location Address:
901 N MONROE ST
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-2104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-209-2728
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2013