Provider First Line Business Practice Location Address:
1801 W BROADWAY AVE STE 2
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:
99201-1819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-755-5100
Provider Business Practice Location Address Fax Number:
509-747-6646
Provider Enumeration Date:
11/02/2006