Provider First Line Business Practice Location Address:
1300 W KNOX 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:
99205-4323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
150-935-4652
Provider Business Practice Location Address Fax Number:
509-354-6400
Provider Enumeration Date:
09/28/2016