Provider First Line Business Practice Location Address:
2321 W 2ND AVE
Provider Second Line Business Practice Location Address:
APT 303
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-5828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-638-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2016