Provider First Line Business Practice Location Address:
905 W RIVERSIDE AVE
Provider Second Line Business Practice Location Address:
SUITE 501
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99201-1016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-744-0778
Provider Business Practice Location Address Fax Number:
509-344-0779
Provider Enumeration Date:
01/25/2007