Provider First Line Business Practice Location Address:
9425 N NEVADA ST
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-5014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-468-7546
Provider Business Practice Location Address Fax Number:
509-465-8886
Provider Enumeration Date:
02/20/2013