Provider First Line Business Practice Location Address:
5329 W RIFLE CLUB CT
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:
99208-9065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-323-1400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/29/2006