Provider First Line Business Practice Location Address:
1303 N DIVISION ST
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:
99202-1930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-456-3600
Provider Business Practice Location Address Fax Number:
509-747-4420
Provider Enumeration Date:
09/05/2013