Provider First Line Business Practice Location Address:
251 E. 5TH AVENUE
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-1332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-838-6501
Provider Business Practice Location Address Fax Number:
509-624-9080
Provider Enumeration Date:
01/16/2007