Provider First Line Business Practice Location Address:
104 W. 5TH AVE.
Provider Second Line Business Practice Location Address:
SUITE 400W.
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204-4800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-353-3960
Provider Business Practice Location Address Fax Number:
509-625-7387
Provider Enumeration Date:
12/11/2006