Provider First Line Business Practice Location Address:
310 N. RIVERPOINT BLVD.
Provider Second Line Business Practice Location Address:
BOX V
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99202-1675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-358-7581
Provider Business Practice Location Address Fax Number:
509-368-6890
Provider Enumeration Date:
03/02/2007