Provider First Line Business Practice Location Address:
200 N BERNARD ST
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:
99201-0206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-354-7951
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2012