Provider First Line Business Practice Location Address:
WEST 101 8TH AVE
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:
99220-2555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-474-2400
Provider Business Practice Location Address Fax Number:
509-474-3129
Provider Enumeration Date:
12/07/2012