Provider First Line Business Practice Location Address:
12 E. ROWAN
Provider Second Line Business Practice Location Address:
SUITE L5
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-979-3099
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2007