Provider First Line Business Practice Location Address:
3704 N NEVADA ST
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207-2968
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-489-4500
Provider Business Practice Location Address Fax Number:
509-489-4330
Provider Enumeration Date:
10/20/2006