Provider First Line Business Practice Location Address:
412 E 30TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99203-2556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-448-7300
Provider Business Practice Location Address Fax Number:
509-448-7382
Provider Enumeration Date:
12/21/2005