Provider First Line Business Practice Location Address:
421 W. RIVERSIDE AVE.
Provider Second Line Business Practice Location Address:
SUITE 900
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-863-9789
Provider Business Practice Location Address Fax Number:
855-630-0757
Provider Enumeration Date:
10/24/2005