Provider First Line Business Practice Location Address:
601 W MAIN AVE
Provider Second Line Business Practice Location Address:
SUITE 1011
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-0636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-1285
Provider Business Practice Location Address Fax Number:
509-344-1011
Provider Enumeration Date:
01/26/2007