Provider First Line Business Practice Location Address:
235 E ROWAN AVE
Provider Second Line Business Practice Location Address:
SUITE 116
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207-1240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-482-3565
Provider Business Practice Location Address Fax Number:
509-482-4011
Provider Enumeration Date:
01/28/2007