Provider First Line Business Practice Location Address:
6821 N COUNTRY HOMES BLVD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99208-4372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-315-3200
Provider Business Practice Location Address Fax Number:
509-651-5130
Provider Enumeration Date:
07/10/2011