Provider First Line Business Practice Location Address:
1312 S SOUTHEAST BLVD
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:
99202-2570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-536-1700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2010