Provider First Line Business Practice Location Address:
910 W 5TH AVE
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-2967
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-625-1915
Provider Business Practice Location Address Fax Number:
509-625-1919
Provider Enumeration Date:
09/23/2008