Provider First Line Business Practice Location Address:
42 E ROWAN AVE
Provider Second Line Business Practice Location Address:
STE A
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:
509-483-3155
Provider Business Practice Location Address Fax Number:
509-487-1636
Provider Enumeration Date:
07/26/2010