Provider First Line Business Practice Location Address:
510 E HASTINGS RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99218-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-467-0755
Provider Business Practice Location Address Fax Number:
509-467-8227
Provider Enumeration Date:
12/30/2013