Provider First Line Business Practice Location Address:
820 S. MCCLELLAN ST
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-747-1144
Provider Business Practice Location Address Fax Number:
509-227-7070
Provider Enumeration Date:
07/18/2012